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state of California <br />Well Completion Report <br />Form DWR188 Submitted 9/1/2022 <br />WCR2022-010231 <br />Owner's Well Number Date Work Began 08/24/2022 Date Work Ended 08/24/2022 <br />Local Permit Agency San Joaquin County Environmental Health Department <br />Secondary Permit Agency Permit Number 43556 Permit Date 07/29/2022 <br />Well Owner (must remain confidential pursuant |o Water«!pode/ifJ3752)Former Use! ,/ <br />Name Andrew Andersen Activity Destroy <br />Mailing Address 17423 S. Enterprise Rd. <br />Former Use Water Supply <br />City Escalon State CA Zip 95320 <br />Well Location^ <br />Address <br />City Escalon <br />17423 S Enterprise RD APN 229-26-004 <br />Latitude <br />Dec. Lat. <br />37 48 <br />Deg. Min. <br />37.8041448 <br />14.9212 <br />Sec. <br />Zip <br />N <br />95320 <br />Longitude <br />County San Joaquin <br />-120 55 59.8915 W <br />Deg. Min. <br />Dec. Long. -120.9333032 <br />Sec. <br />Township <br />Range 09 E <br />Section <br />0 <br />36 <br />1 S <br />Baseline Meridian Mount Diablo <br />Vertical Datum Horizontal Datum WGS84 <br />Ground Surface Elevation <br />Elevation Accuracy <br />Location Accuracy Location Determination <br />Method <br />Elevation Determination Method <br />Borehole Information yy^r LeVi^'iandifie^^ <br />Orientation Vertical Specify <br />Drilling Method Drilling Fluid <br />Depth to first water <br />Depth to Static <br />Water Level <br />(Feet below surface) <br />Total Depth of Boring <br />Total Depth of Completed Well 124 <br />Feet <br />Feet <br />Estimated Yield* <br />Test Length <br />(Feet) <br />(GPM) <br />(Hours) Total Drawdown <br />Date Measured <br />Test Type <br />(feet) <br />*May not be representative of a well's long term yield. <br />Destruction Details: <br />Pump bentonite from the bottom to the top of a 6in old well. <br />Other Observations: <br />Form DWR 188 rev. 12/19/2017 Page J_of^